Tumor Features

Question 1

describe local effects of benign and malignant tumors

Answer 1

• submucosal leiomyoma –> bleeding
• tumor (benign of malignant in gut) –> bowel obstruction
• pituitary adenoma –> destruction of the remaining gland
• gastrointestinal tumors/urogenital tumors –> bleeding
• ovarian tumors –> torsion

Question 2

describe the hormonal effects of benign of malignant tumors

Answer 2

• B cell adenoma in pancreas –> insulin production –> hypoglycemia
• adrenal cortex adenoma –> steroid production –> secondary effects
• neuroendocrine (carcinoid) tumor –> hormones –> carcinoid syndrome

Question 3

describe cancer cachexia and name the factors producing cachexia

Answer 3

progressive loss of fat and lean body mass with weakness, anorexia, anemia. Cachexia is NOT due to nutritional demand by tumor

• factors producing cachexia:
  
  • reduced food intake
  • reduced synthesis and storage of fat, increased mobilization of FAs from adipocytes
  • TNF-a

Question 4

describe paraneoplastic syndrome

Answer 4

symptom complex in patients with cancer that cannot be readily explained, either by local or distant spread of the tumor or by the elaboration of the hormones indigenous to the tissue of origin

Question 5

_____ is the gold standard of cancer diagnosis

Answer 5

microscopic tissue examination is the gold standard of cancer diagnosis

Question 6

describe the steps in routine tissue processing

Answer 6

• formalin fixation
• dehydration in graded alcohol
• xylene
• paraffin embedding
• sections cut and stained with H&E

Question 7

describe the purpose of immunocytochemistry

Answer 7

• detects nuclear or cytoplasmic proteins with aid of specific antibody
• used in tumor diagnosis to detect cell of origin

Question 8

describe the frozen section method

Answer 8

Question 9

describe fine needle aspiration method

Answer 9

Question 10

describe cytologic methods

Answer 10

Question 11

describe the flow cytometry method

Answer 11

Question 12

describe immunocytochemistry method

Answer 12

Question 13

list the common immunohstochemical stains

Answer 13

• epithelium = keratin
• mesenchyme = vimentin
• muscle = desmin
• prostatic epithelium = PSA
• thyroid follicular cells = thyroglobulin
• neuroendocrine cells = chromogranin
• melanoma = S100/HMB45/Melan A

Question 14

which cancer is PSA a marker for?

Answer 14

prostatic adenocarcinoma

Question 15

which cancers is CEA a tumor marker for?

Answer 15

• colonic adenocarcinoma
• pancreatic adenocarcinoma
• breast adenocarcinoma
• gastric adenocarcinoma

Question 16

what cancer is AFP a tumor marker for?

Answer 16

hepatocellular carcinoma

Question 17

one probable factor for higher incidence of colorectal cancer in US is ____

Answer 17

one probable factor for higher incidence of colorectal cancer in US is high fat content of diet

Question 18

____ has a protective effect against UV light and skin cancer

Answer 18

skin pigmentation has a protective effect against UV light and skin cancer

Question 19

____ infection can lead to Burkitt’s Lymphoma

Answer 19

Epstein-Barr virus infection can lead to Burkitt’s Lymphoma

Question 20

peak age of cancer is ____ years

list 2 possible factors for this

Answer 20

peak age of cancer is 55-75 years

• accentuated somatic mutations
• decline in immune competence

Question 21

___, ___ and ___ are common childhood cancers

Answer 21

neuroblastomas, Wilms tumor and retinoblastoma are common childhood cancers

Question 22

describe inhereited cancer syndrome (AD)

Answer 22

• multiple endocrine neoplasia (MEN1, RET)
• Li-Fraumeni sydrome (P53)
• familial adenomatous polyposis (APC)

Question 23

describe syndromes of defective DNA repair

Answer 23

• AD:
  
  • hereditary non-polyposis colon cancer
    
    • MLH1, MSH2, MSH6, PMS2
• AR:
  
  • xeroderma pigmentosa –> sq. cell cancer
  • ataxia telengiectasia –> lymphoma, ALL
  • Fanconi’s anemia –> AML

Question 24

describe acquired preneoplastic conditions

Answer 24

• cirrhosis of liver –> HCC
• ulcerative colitis –> colonic adenocarcinoma